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1.
Br J Clin Psychol ; 62(1): 158-179, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36342851

RESUMEN

OBJECTIVES: Mental health problems are increasing at an alarming rate, calling for the need for more cost-effective and easily accessible interventions. Visual images and sounds depicting nature have been found to have positive effects on individuals' mood and well-being; however, the combined effects of images and sounds have been scarcely investigated. This study therefore aimed to compare the mood effects of viewing nature-related soothing images versus listening to soothing sounds versus a combination of both. METHODS: In this study, 149 participants aged 18-83 years old (M = 35.88, SD = 15.63; 72.5% female, male 26.8%, .7% transgender) were randomised into three intervention conditions: images only, sounds only or combined (images and sounds). Baseline depressive and anxiety symptoms were indexed, and four outcome variables (positive affect, negative affect, serenity affect and depressive mood states) were measured pre- and post-intervention. RESULTS: Findings showed that all participants, regardless of group, reported a decrease in negative affect, positive affect and depressive mood as well as an increase in serenity affect (including feelings of soothe). However, there were no group differences. Exploratory analyses found that individuals with higher levels of depressive and anxiety symptoms at baseline experienced greater reduction in negative affect and depressive mood state, as well as a larger increase in serenity affect. CONCLUSIONS: These findings therefore provide preliminary evidence that, upon further research and development, images and sounds depicting nature can potentially be developed for use as an effective tool to improve mood and well-being.


Asunto(s)
Afecto , Depresión , Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Depresión/psicología , Ansiedad/psicología , Emociones
2.
Br J Clin Psychol ; 61(2): 177-196, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34716598

RESUMEN

OBJECTIVES: Attitudes towards peers who are not perceived to be legitimately depressed, or whose depression 'authenticity' is questioned, represent a current gap in adolescent depression stigma research. This research study, therefore, investigated how perceptions of depression inauthenticity are framed in adolescent Reddit communities. METHODS: This observational study used an internet-mediated, qualitative methodology to analyse forum posts from April 2019 to January 2020 on three adolescent-based subreddits. Posts were extracted using the Baumgartner Reddit Corpus. Identifiable information was removed to protect anonymity. RESULTS: Inductive thematic analysis identified two overarching themes, namely, public stigma and self-stigma associated with depression inauthenticity. Public stigma could be further dissected into five subthemes: (i) dichotomy between 'real' and 'fake depression'; (ii) aggression towards 'fakers'; (iii) stereotypes; (iv) attention; and (v) diagnosis. On the other hand, the theme of self-stigma consisted of subthemes: (i) self-doubt and (ii) validation and invalidation. CONCLUSIONS: Adolescents framed a dichotomy between so-called 'real' and 'fake depression', with hostility directed at peers perceived to be 'fake depressed'. Perceptions of depression inauthenticity were confused and inconsistent. Public and self-stigma towards depression inauthenticity enforced barriers to help-seeking. While future research should investigate to what extent these observations based on online forums mimic stigma in real-life settings, our findings have highlighted the needs for 'fake depression' stigma to be addressed by adolescent depression literacy and stigma interventions. Recent movements towards reconceptualizing depression as a dimensional construct may help to challenge these stigmatizing views of a dichotomy between 'real' and 'fake' depression. PRACTITIONER POINTS: There is widespread stigma concerning perceived inauthenticity related to depression in these online adolescent communities, with vitriol targeted at peers perceived to be so-called 'fake depressed'. Adolescent depression literacy and stigma programmes should tackle stigma towards perceived inauthenticity and promote the message that all adolescent distress deserves attention and help. This involves challenging perceptions that only supposedly 'authentic', diagnosed, or diagnosable, depression is worthy of attention and support. Prevention Programmes should work to mitigate barriers to help-seeking posed by misunderstandings that distress which is kept secret is more 'authentic', and tackle gender and age stereotypes surrounding perceived inauthenticity. There is a need for clinically approved online resources targeted at adolescents who feel unsure about whether their symptoms could be indicators of depression, and to make professional advice and help more accessible for young people.


Asunto(s)
Depresión , Trastornos Mentales , Adolescente , Atención , Humanos , Aceptación de la Atención de Salud , Estigma Social
3.
Psychol Med ; 51(8): 1233-1248, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-34109934

RESUMEN

Early maladaptive schemas (EMS) are broad, pervasive themes and patterns of emotions, memories, cognition and physical sensations that impede the goal of individuals. Maladaptive behaviours can occur as a response to maladaptive or negative schemas, often culminating in depression or anxiety. The current meta-analysis integrates the existing literature to estimate the magnitude of effect of association between EMS and depression among adolescents and young adults. A systematic search of seven different databases including Embase, CINAHL, Medline, ASSIA, Psych INFO, Scopus and Web of Science was carried out identifying 24 relevant studies of adolescents (10-18 years) and young adults (19-29 years). The random-effect model estimate for association between overall EMS and depression was r = 0.56 (95% CI 0.49-0.63, Z = 12.88, p ≤ 0.0001), suggesting higher predominant EMS significantly linked to higher levels of depressive symptoms, with a large effect size. Separate meta-analytical results with schema domains indicated moderately stronger associations between schemas of disconnection/rejection, impaired autonomy/performance and other-directedness with depression. Age and gender were not found to have any significant moderating effect on the associations. The findings suggest that it is vital for clinicians to identify specific maladaptive schemas contributing towards depression, to have a better understanding of underlying cognitive processes and in turn promote psychological health, well-being and resilience in adolescents and young adults. Furthermore, findings will also assist clinicians to focus more on the content of three significant schema domains, which emerged as particularly salient factors underlying adolescent depression.


Asunto(s)
Adaptación Psicológica , Depresión , Adolescente , Adulto , Humanos , Adulto Joven , Ansiedad/epidemiología , Trastornos de Ansiedad , Depresión/epidemiología , Depresión/psicología , Emociones , Niño
4.
Aging Ment Health ; 23(12): 1684-1690, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-30430850

RESUMEN

Objectives: Fear of falling is common amongst older adults with and without a prior experience of falling. It is related to decreased quality of life, isolation, and institutionalisation. It also poses a risk for future falls when activity is avoided because of fear of falling and muscle deconditioning occurs. Relatively little is known about the psychological factors underpinning fear of falling. This study explored the relationship between emotion regulation and fear of falling in community dwelling older adults. Method: A sample of 117 older adults (>65 years) were recruited from community based exercise classes, falls reduction classes, NHS and charity organisations. Self-reported measures included the Falls Efficacy Scale-International (FES-I), the Fear of Falling Behaviour Questionnaire (FFABQ), the Difficulties in Emotion Regulation Scale (DERS) and the Hospital and Anxiety Depression Scale (HADS). Results: A significant positive correlation was found between emotion regulation and fear of falling, as well as between emotional regulation and fear-related avoidance behaviour. A regression model found that after controlling for depression and age, emotion regulation was no longer significantly related to fear of falling. Conclusions: Fear of falling is associated with emotion regulation difficulties in community dwelling older adults. However, this link no longer exists once depression is controlled for. The key clinical implication is the importance of the assessment of depression in older adults with a fear of falling. Future research should use a longitudinal design to further unpick the causal relationships between these variables.


Asunto(s)
Accidentes por Caídas/estadística & datos numéricos , Reacción de Prevención , Regulación Emocional , Miedo/psicología , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Masculino , Calidad de Vida , Encuestas y Cuestionarios
5.
J Ment Health ; 28(4): 389-396, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30451053

RESUMEN

Background: Despite global recognition of the significance of adolescents' mental health it remains a neglected area in research and health policy in Pakistan. Aim: To examine the rates of depression and anxiety and to assess the level of well-being among Pakistani adolescents. Methods: A cross-sectional sample of 1124 adolescents (age 11-18 years) was recruited from schools in Rawalpindi, Pakistan. Results: 17.2% and 21.4% participants were identified to be probable cases of depression and anxiety, respectively. The mean well-being score of the participants was 65.79 (S.D = 12.84). Girls were more anxious than boys. Depressive symptoms and well-being were significantly associated with age. Poor economic status, lower level of education and more negative life events were significantly associated with higher levels of depression and anxiety symptoms and poor well-being. Conclusion: To our knowledge, this is the first school-based observational research exploring the rates of symptoms of depression and anxiety as well as well-being among 11-18 years old in Pakistan. This study concludes that mental health of Pakistani adolescents is an important area of public health concern and provides information for making policy level decisions regarding evaluation, prevention and intervention of mental health problems among adolescents in Pakistan.


Asunto(s)
Ansiedad/epidemiología , Depresión/epidemiología , Salud Mental/estadística & datos numéricos , Adolescente , Niño , Estudios Transversales , Países en Desarrollo , Femenino , Humanos , Masculino , Pakistán/epidemiología , Escalas de Valoración Psiquiátrica
7.
J Adolesc ; 69: 163-174, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30326397

RESUMEN

INTRODUCTION: Social anxiety disorder is a prevalent mental illness with a young onset age. Preliminary evidence suggested that low self-compassion may contribute to adult social anxiety, but research with youth has lagged far behind. This study investigated the relationship between selfcompassion and social anxiety in adolescents. It also examined the mediating role of three cognitive mechanisms: fear of negative evaluation, self-focused attention, and cognitive avoidance. METHODS: A total of 316 adolescents (age 14-18, 54% male) recruited in Scotland, UK, completed 7 questionnaires. RESULTS: Self-compassion was inversely correlated with social anxiety with a large effect size (r = -.551). This was partially mediated by fear of negative evaluation and cognitive avoidance, but not self-focused attention. Selfcompassion also predicted social anxiety above depression and anxiety symptoms. CONCLUSIONS: Our findings suggested that self-compassion could be an important factor in the development of social anxiety, and hence therapeutic techniques targeting self-compassion could potentially be beneficial in preventing or treating adolescent social anxiety.


Asunto(s)
Empatía , Fobia Social/psicología , Autoimagen , Adolescente , Miedo/psicología , Femenino , Humanos , Masculino , Escocia , Encuestas y Cuestionarios
8.
J Child Psychol Psychiatry ; 57(11): 1277-1286, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27418025

RESUMEN

BACKGROUND: Studies have identified perturbations in facial processing in bipolar disorder and major depressive disorder (MDD), but their relationship to genetic risk and early development of illness is unclear. METHODS: The Scottish Bipolar Family Study is a prospective longitudinal investigation examining young individuals (age 16-25) at familial risk of mood disorder. Participants underwent functional MRI using an implicit facial processing task employing angry and neutral faces. An explicit facial expression recognition task was completed outside the scanner. Clinical outcomes obtained 2 years after the scan were used to categorise participants into controls (n = 54), high-risk individuals who had developed MDD (HR MDD; n = 30) and high-risk individuals who remained well (HR Well, n = 43). RESULTS: All groups demonstrated activation patterns typically observed during facial processing, including activation of the amygdala, hippocampus, fusiform gyrus and middle frontal regions. Notably, the HR MDD group showed reduced activation of the anterior cingulate gyrus versus both the control and HR Well group for angry faces, and versus the HR Well group for neutral faces. Outside the scanner, the HR MDD group was less accurate in recognising fearful expressions than the HR Well group. CONCLUSIONS: Here, we demonstrate functional abnormalities of the anterior cingulate cortex alongside facial emotional recognition deficits in high-risk individuals in the early stages of depression compared with both controls and at-risk individuals who remained well. These neural changes were associated with a current or future diagnosis of MDD and were not simply associated with increased familial risk.


Asunto(s)
Trastorno Depresivo Mayor/fisiopatología , Expresión Facial , Giro del Cíngulo/fisiopatología , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Predisposición Genética a la Enfermedad , Humanos , Masculino , Pronóstico , Riesgo , Escocia , Adulto Joven
9.
J Child Psychol Psychiatry ; 56(11): 1239-48, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25471444

RESUMEN

BACKGROUND: Cognitive Bias Modification (CBM) has been shown to change interpretation biases commonly associated with anxiety and depression and may help ameliorate symptoms of these disorders. However, its evidence base for adolescents is scarce. Previous results have been hard to interpret because of methodological issues. In particular, many studies have used negative bias training as the control condition. This would tend to inflate any apparent benefits of CBM compared to a neutral control. Most studies also only examined the effects of a single training session and lacked follow-up assessment or ecologically valid outcome measures. METHOD: Seventy-four adolescents, aged 16-18 years, were randomised to two sessions of CBM training or neutral control. Interpretation bias and mood were assessed three times: at baseline, immediately post-training and 1 week post-training. A controlled experimental stressor was also used, and responses to everyday stressors were recorded for 1 week after training to assess responses to psychological challenges. Feedback for the training programme was collected. RESULTS: The CBM group reported a greater reduction in negative affect than control participants. However, other hypothesised advantages of CBM were not demonstrated. Regardless of training group, participants reported increased positive interpretations, decreased negative interpretations, reduced depressive symptoms and no change in trait anxiety. The two groups did not differ in their stress reactivity. After controlling for group differences in training performance, all the mood effects disappeared. CONCLUSIONS: When tested under stringent experimental conditions the effects of CBM in healthy adolescents appear to be minimal. Future studies should concentrate on participants with elevated cognitive biases and/or mood symptoms who may be more sensitive to CBM.


Asunto(s)
Afecto/fisiología , Terapia Cognitivo-Conductual/métodos , Evaluación de Resultado en la Atención de Salud , Pensamiento/fisiología , Adolescente , Femenino , Voluntarios Sanos , Humanos , Masculino
10.
Behav Cogn Psychother ; 42(6): 747-59, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24382088

RESUMEN

BACKGROUND: The IAPT services provide high and low intensity psychological treatments for adults suffering from depression and anxiety disorders using a stepped care model. The latest national evaluation study reported an average recovery rate of 42%. However, this figure varied widely between services, with better outcomes associated with higher "step-up" rates between low and high intensity treatments. AIMS: This study aimed to compare the two intensity groups in an IAPT service in Suffolk. METHOD: This study adopted a between groups design. A sample of 100 service users was randomly selected from the data collected from an IAPT service in Suffolk between May 2008 and February 2011. The treatment outcomes, drop-out rate, and other characteristics were compared between those who received high and low intensity treatments. RESULTS: The high intensity group received, on average, more sessions and contact time. They received more CBT sessions and less guided self-help. There were no group differences in terms of the drop-out and appointment cancellation rates. Analyses on clinical outcomes suggested no group difference but demonstrated an overall recovery rate of 52.6% and significant reduction in both depression and anxiety symptoms. CONCLUSIONS: Despite methodological limitations, this study concludes that the service as a whole achieved above-average clinical outcomes. Further research building upon the current study in unpacking the relative strengths and weaknesses for the high and low intensity treatments would be beneficial for service delivery.


Asunto(s)
Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/terapia , Terapia Cognitivo-Conductual/métodos , Terapia Cognitivo-Conductual/estadística & datos numéricos , Servicios de Salud Comunitaria/estadística & datos numéricos , Trastorno Depresivo/epidemiología , Trastorno Depresivo/terapia , Pacientes Desistentes del Tratamiento/psicología , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Adulto , Trastornos de Ansiedad/psicología , Trastorno Depresivo/psicología , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Motivación , Autocuidado/métodos , Autocuidado/estadística & datos numéricos , Encuestas y Cuestionarios , Revisión de Utilización de Recursos , Adulto Joven
11.
Explore (NY) ; 19(3): 405-416, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-35973933

RESUMEN

OBJECTIVE: The aim of this project was to conduct a randomised control study to examine whether outdoor mindful walking in nature can effectively improve university students' sleep quality, mood, and mindfulness during the Covid-19 pandemic in the U.K. METHODS: Participants were measured at T0 (pre-study baseline), T1 (pre-intervention), T2 (post-intervention), and T3 (follow-up). A total of 104 participants (female = 94) who were experiencing sleep difficulties were randomly allocated to either an experimental (i.e., nature) or control (i.e., urban) walking environment. Participants in each walking condition independently undertook a daily 35-minute walk for a week (7 days). Subjective sleep quality, total mood disturbance, mindfulness, and degree of nature connectedness, and participants' perspectives on the intervention, were collected. RESULTS: Findings suggest that both groups resulted in significant improvements in participants' trait mindfulness, sleep quality and mood after the intervention. However, mindful walking in nature did not bring additional mental health benefits to participants relative to those who walked an urban environment. Participants provided their perspectives about the intervention, which will assist with future intervention development. CONCLUSIONS: Findings contribute to the evidence-base on the effectiveness of outdoor mindful walking interventions for enhancing mental health. These findings contribute new knowledge on how mindful walking outdoors reduces university students' mood disturbances and improves sleep quality and mindfulness level.


Asunto(s)
COVID-19 , Atención Plena , Humanos , Femenino , COVID-19/prevención & control , Calidad del Sueño , Atención Plena/métodos , Universidades , Pandemias , Caminata , Estudiantes/psicología
12.
Cereb Cortex Commun ; 4(4): tgad020, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38089939

RESUMEN

Major depressive disorder often originates in adolescence and is associated with long-term functional impairment. Mechanistically characterizing this heterogeneous illness could provide important leads for optimizing treatment. Importantly, reward learning is known to be disrupted in depression. In this pilot fMRI study of 21 adolescents (16-20 years), we assessed how reward network disruption impacts specifically on Bayesian belief representations of self-efficacy (SE-B) and their associated uncertainty (SE-U), using a modified instrumental learning task probing activation induced by the opportunity to choose, and an optimal Hierarchical Gaussian Filter computational model. SE-U engaged caudate, nucleus accumbens (NAcc), precuneus, posterior parietal and dorsolateral prefrontal cortex (PFWE < 0.005). Sparse partial least squares analysis identified SE-U striatal activation as associating with one's sense of perceived choice and depressive symptoms, particularly anhedonia and negative feelings about oneself. As Bayesian uncertainty modulates belief flexibility and their capacity to steer future actions, this suggests that these striatal signals may be informative developmentally, longitudinally and in assessing response to treatment.

13.
Res Dev Disabil ; 138: 104516, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37141676

RESUMEN

BACKGROUND: Depression is highly prevalent in autistic children and adolescents. Despite this, little is known about the nature of the autistic child's subjective experience of depression and the impact of depression on their lives. METHODS: We therefore conducted a qualitative study using thematic analysis with 7 autistic children and adolescents and their parents to identify common themes and individual differences. All children had previously experienced at least one depressive episode. RESULTS: Six main themes were identified: (1) Autism related experiences; (2) Difficulties with peer relationships; (3) Co-occurring relationships between anxiety and depression; (4) Impactful pessimism and anhedonia; (5) Impactful difficulties with focus and concentration and (6) Feelings of irritability, including aggressive behaviours. Parent's accounts of their children's experience of depression mirrored the child's perspective. Novel findings included reports of depression related restriction of diet variety and masking of mental health difficulties. Children and parents linked being autistic and developing depression, referring to the difficulties of being autistic in a complex, neurotypical world. CONCLUSIONS: These results highlight key challenges that autistic children and their families experience, calling for increased awareness of the impact of depression on autistic young people.


Asunto(s)
Trastorno Autístico , Niño , Humanos , Adolescente , Trastorno Autístico/psicología , Depresión/epidemiología , Padres/psicología , Ansiedad/epidemiología , Emociones
14.
Front Behav Neurosci ; 17: 1124940, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37397127

RESUMEN

Irritability is a core symptom of adolescent depression, characterized by an increased proneness to anger or frustration. Irritability in youth is associated with future mental health problems and impaired social functioning, suggesting that it may be an early indicator of emotion regulation difficulties. Adolescence is a period during which behavior is significantly impacted by one's environment. However, existing research on the neural basis of irritability typically use experimental paradigms that overlook the social context in which irritability occurs. Here, we bring together current findings on irritability in adolescent depression and the associated neurobiology and highlight directions for future research. Specifically, we emphasize the importance of co-produced research with young people as a means to improve the construct and ecological validity of research within the field. Ensuring that our research design and methodology accurately reflect to lives of young people today lays a strong foundation upon which to better understand adolescent depression and identify tractable targets for intervention.

15.
Dev Cogn Neurosci ; 60: 101223, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36870214

RESUMEN

BACKGROUND: Earlier pubertal timing is associated with higher rates of depressive disorders in adolescence. Neuroimaging studies report brain structural associations with both pubertal timing and depression. However, whether brain structure mediates the relationship between pubertal timing and depression remains unclear. METHODS: The current registered report examined associations between pubertal timing (indexed via perceived pubertal development), brain structure (cortical and subcortical metrics, and white matter microstructure) and depressive symptoms in a large sample (N = âˆ¼5000) of adolescents (aged 9-13 years) from the Adolescent Brain Cognitive Development (ABCD) Study. We used three waves of follow-up data when the youth were aged 10-11 years, 11-12 years, and 12-13 years, respectively. We used generalised linear-mixed models (H1) and structural equation modelling (H2 & H3) to test our hypotheses. HYPOTHESES: We hypothesised that earlier pubertal timing at Year 1 would be associated with increased depressive symptoms at Year 3 (H1), and that this relationship would be mediated by global (H2a-b) and regional (H3a-g) brain structural measures at Year 2. Global measures included reduced cortical volume, thickness, surface area and sulcal depth. Regional measures included reduced cortical thickness and volume in temporal and fronto-parietal areas, increased cortical volume in the ventral diencephalon, increased sulcal depth in the pars orbitalis, and reduced fractional anisotropy in the cortico-striatal tract and corpus callosum. These regions of interest were informed by our pilot analyses using baseline ABCD data when the youth were aged 9-10 years. RESULTS: Earlier pubertal timing was associated with increased depressive symptoms two years later. The magnitude of effect was stronger in female youth and the association remained significant when controlling for parental depression, family income, and BMI in females but not in male youth. Our hypothesised brain structural measures did not however mediate the association between earlier pubertal timing and later depressive symptoms. CONCLUSION: The present results demonstrate that youth, particularly females, who begin puberty ahead of their peers are at an increased risk for adolescent-onset depression. Future work should explore additional biological and socio-environmental factors that may affect this association so that we can identify targets for intervention to help these at-risk youth.


Asunto(s)
Depresión , Pubertad , Humanos , Masculino , Adolescente , Femenino , Encéfalo
16.
Wellcome Open Res ; 7: 198, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-37680686

RESUMEN

Introduction - Despite extensive debate surrounding mental health services in the UK, there is little empirical evidence regarding the views of those who use them. We therefore used data collected as part of a wider survey to examine satisfaction amongst those seeking treatment from mental and physical health services. Methods - An online survey designed with input from people with experience of mental illness was used to measure satisfaction with NHS mental and physical health services at first contact and in the previous 12 months. Results - A total of 2187 people responded. During the 12 months prior to the survey, 526 respondents had sought mental health care and 1379 had sought physical health care. Participants were significantly more satisfied with their most recent contact with mental health services (48.1% very/satisfied) than with their first contact (38.2% very/satisfied). More than 1 in 10 respondents who sought mental health care (11.4%) stated that they received no treatment/support from the NHS, compared to approximately 1 in 20 respondents who sought physical health care (4.6%). Of those who received the mental health treatment they requested (n = 424), most were satisfied or very satisfied with their care (54.7%), although this was lower than the corresponding figure (77.9%) for satisfaction with physical health care received (n = 1190). Conclusion -There was evidence that mental health services are satisfactory for a slim majority of users, but people were generally more satisfied with NHS physical health care. This survey was conducted in the year prior to the coronavirus disease 2019 pandemic. Future research could examine what influences satisfaction with care and whether this picture has changed following the emergence of the pandemic and consequent impact on health service delivery and daily life.

17.
J Affect Disord ; 308: 221-228, 2022 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-35429539

RESUMEN

BACKGROUND: Major Depressive Disorder is a severe and highly disabling mental illness. Almost all self-reported questionnaires have overlooked the interpersonal symptoms of depression which are important across gender and culture. The Multidimensional Depression Assessment Scale (MDAS) developed by Cheung and Power (2012) entails comprehensive emotional, cognitive, somatic, and interpersonal subscales. It addresses the criticism that existing self-report depression scales might not cover sufficient phenomenological heterogeneity of depression. The current study aimed to evaluate the psychometric properties of the MDAS across gender and four major ethnic groups of Caucasian, Black, Asian and Hispanic, including reliability and concurrent validity against the Centre for Epidemiological Studies Depression Scale (CESD) and Patients Health Questionnaire (PHQ-9). It also aimed to establish a stable factor structure across gender and ethnic groups and test the measurement invariance to enhance its potential for clinical use. METHODS: A community sample of 3499 participants from four ethnic groups were recruited via online crowdsourcing sites of Qualtrics and Amazon M Turk. Each individual completed a demographic questionnaire, the MDAS, CESD and PHQ-9. RESULTS: There was good internal consistency (Cronbach's alpha >0.90) and concurrent reliability across gender and ethnic groups. Strict measurement invariance was established for MDAS over a four-factor factor structure corresponding to the four subscales. CONCLUSIONS: The MDAS showed good psychometric properties and measurement invariance of a four-factor structure, suggesting its potential to be used in clinical settings across gender and ethnic groups. LIMITATIONS: Participants all answered the questionnaires in English, which could hinder cultural variations in their expression of symptoms.


Asunto(s)
Trastorno Depresivo Mayor , Etnicidad , Depresión/psicología , Trastorno Depresivo Mayor/diagnóstico , Análisis Factorial , Hispánicos o Latinos , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
18.
J Child Psychol Psychiatry ; 52(1): 24-32, 2011 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-20629805

RESUMEN

BACKGROUND: Negative biases in the interpretation of ambiguous material have been linked to anxiety and mood problems. Accumulating data from adults show that positive and negative interpretation styles can be induced through cognitive bias modification (CBM) paradigms with accompanying changes in mood. Despite the therapeutic potential of positive training effects, training paradigms have not yet been explored in adolescents. METHODS: Eighty-two healthy adolescents (aged 13-17 years) were randomly allocated to either positive or negative CBM training. To assess training effects on interpretation bias, participants read ambiguous situations followed by test sentences with positive or negative interpretations of the situation. Participants rated the similarity of these sentences to the previously viewed ambiguous situations. Training effects on negative and positive affect were assessed using visual analogue scales before and after training. RESULTS: After training, adolescents in the negative condition drew more negative and fewer positive interpretations of new ambiguous situations than adolescents in the positive condition. Within the positive condition, adolescents endorsed more positive than negative interpretations. In terms of mood changes, positive training resulted in a significant decrease in negative affect across participants, while the negative condition led to a significant decrease in positive affect among male participants only. CONCLUSION: This is the first study to demonstrate the plasticity of interpretation bias in adolescents. The immediate training effects on mood suggest that it may be possible to train a more positive interpretation style in youth, potentially helping to protect against anxiety and depressive symptoms.


Asunto(s)
Afecto , Cognición , Terapia Cognitivo-Conductual/métodos , Psicología del Adolescente , Percepción Social , Adolescente , Femenino , Humanos , Juicio , Masculino , Pruebas Psicológicas , Resultado del Tratamiento
19.
Psychol Psychother ; 94 Suppl 2: 339-358, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-32347655

RESUMEN

OBJECTIVES: Research into adolescent mental health has tended to focus on primary attachment relationships. However, the effect of secondary attachment relationships and the role of culture remain under-explored. This study examined the associations between primary attachment, secondary attachment, and coping strategies (task-focused, emotion-focused, and avoidant coping) with psychological well-being and psychological distress in adolescents across two cultural settings. DESIGN: A cross-sectional study. METHOD: An identical test battery was used across two geographic sites in Pakistan (N = 510; 12-18 years; 51.5% male; mean age = 14.50) and Scotland (N = 610; 12-18 years; 53.6% male; mean age = 13.97). Associations were tested separately in each sample using moderated mediation modelling for the outcome variables: psychological well-being and psychological distress. RESULTS: For psychological well-being, all three coping strategies were significant partial mediators and secondary attachment was a significant moderator in both samples. Secondary attachment moderated the association between emotion-focused coping and psychological well-being in the Pakistani sample only. For psychological distress, task-focused coping was a significant full mediator in the Pakistani sample only. In contrast, for the Scottish sample, task-focused coping and emotion-focused coping were significant partial mediators. Secondary attachment's direct effect on psychological distress was significant in both samples. Secondary attachment also moderated the association between emotion-focused coping and psychological distress in the Pakistani sample only. CONCLUSIONS: The cross-cultural evidence suggests that alongside primary attachment, it is important to target secondary attachment through coping strategies, in order to enhance psychological well-being and lessen psychological distress in adolescents. PRACTITIONER POINTS: Secondary attachment plays a different role from primary attachment in adolescents. Therefore, it is important to target both primary attachment and secondary attachment security to enhance psychological well-being and lessen psychological distress. Cross-cultural differences in coping suggest that differential strategies to target different coping dimensions may enhance adolescent well-being across cultures. These cross-cultural differences highlight the ethical importance of cultural sensitivity among clinicians working with adolescents globally.


Asunto(s)
Adaptación Psicológica , Salud Mental , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Pakistán , Escocia , Encuestas y Cuestionarios
20.
J Affect Disord ; 295: 1462-1473, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34563389

RESUMEN

BACKGROUND: Early maladaptive schemas (EMS) are self-perpetuating dysfunctional cognitive structures that have been linked with youth psychological health and play a significant role in developing and maintaining psychological distress, including anxiety symptoms. METHOD: The present meta-analysis synthesises the existing literature to evaluate the strength of association between EMS and anxiety symptoms among adolescents and young adults (aged 10-29 years). The systematic literature search was carried out in October 2019 using six different databases. RESULTS: Our systematic search has identified 15 studies, comprising of 9515 participants (Mean age = 18.95, SD = 5.30). All the studies assessed were either cross-sectional or longitudinally designed. The random effect estimate for overall EMS with anxiety was r = 0.59 (95% Cl = 0.50 to 0.68, Z = 9.69, p < 0.0001), indicating a strong association between EMS and anxiety. When different schema domains were investigated separately, anxiety was shown to have significantly stronger associations with the schema domains of disconnection/rejection (r = 0.50), impaired autonomy/performance (r = 0.47) and other-directedness (r = 0.49). Further, females were found to have higher schemas of hypervigilance and other-directedness and associated anxiety symptoms compared to males. LIMITATIONS: Meta-analytical results were limited to articles published in peer-reviewed journals in English language, inducing an upward publication bias and limiting the generalizability of the findings. CONCLUSIONS: The findings highlight schemas related to disconnection/rejection, impaired autonomy/performance and other-directedness as particularly salient precursors of anxiety symptoms, providing evidence for clinicians to target these particular schemas during prevention, intervention, and management of anxiety disorder.


Asunto(s)
Adaptación Psicológica , Trastornos de Ansiedad , Adolescente , Adulto , Ansiedad/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Adulto Joven
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